CMS Price Transparency Data

Psychotherapy session (60 minutes)

Facility: Boone County Hospital

Billing Code: 90837 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 90837
  • Insurance Median: $350
  • Cash Discount Price: $616
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Psychotherapy session (60 minutes) at Boone County Hospital is $350. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $616. Compared to the federal Medicare reimbursement reference rate of $181.34, this hospital’s rate is 1.93x the Medicare baseline. Located in 1015 Union Street, Boone, IA.
Cash / Self-Pay
$616

Average discount available for prompt cash payment at this facility.

Insurance Median
$350

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$181.34

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $181.34 (100%)
Cash / Self-Pay: $616 (340%)
Insurance Median: $350 (193%)
Cash: $616 (340% of Medicare)
Ins. Median: $350 (193% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $181.34 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Tricare $181 100%
Wellmark Hmo $280 154%
Wellmark Ppo - All Other Plans $308 170%
Choice Care Mcr Adv - All Plans $316 174%
Humana $316 - $693 174%
Iowa Hlth Adv - All Plans $316 174%
Mt Carmel Hp - All Plans $316 174%
Amerigroup Mcr Adv - All Other Plans $319 176%
Aetna $323 - $601 178%
Meridian Mcaid - All Plans $346 191%
Iowa Total Care Mcaid - All Plans $353 195%
Medicaid / KanCare $357 197%
Healthsmart Accell Network $539 297%
Medical Associates Hp-All Plans $578 319%
Healthsmart Ppo - All Other Plans $616 340%
Health Alliance-All Plans $693 382%
Midlands Choice-All Plans $708 390%
Mutually Preferred-All Plans $732 404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1015 Union Street, Boone, IA 50036
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals